Admisión – Colegio Internacional

Forms

Then we put at your disposal the following forms to complete and send.

Form Medical card

Personal data:

Full Name

Home

Sex

Date of birth

Phone

Personal history:

(During the practice of physical activity)

Family history, medical conditions of the Fathers and Mothers before the age of 55:

Conditions

Heart Condition High Blood Pressure Diabetes Obesity

Sudden death in the family:

Sudden death in the family

Physical examination:

Weight

Height

Cardiovascular exam:

Pulse

Blood Pressure

Auscultation

Review respiratory:

Rate respiratory

Auscultation

Disorders:

Disorders orthopedic:

Disorders neurological:

Disorders metabolic:

Takes any medication currently

Known allergies

Medications that are usually taken for fever or pain

Authorizes you to provide these medicines in the school:

Yes/No

Disease that limit your physical activity

Disease that limits their normal attendance to classes

Remarks:

In the current moment, I certify that the declarant does not present any impediment in their pediatric examination, except if there is pathology that was not detectable by clinical evaluation, in order to make physical activity training and sports, recreational, according to age and level of physical fitness, weather conditions, comfortable, and under the supervision of the teacher of Physical Education.

Doctor's name

Registration

Phone

The name of the father, mother or guardian

Phone

Urgency

Phone

Sanatorium

ADMISSION

REGISTRATION APPLICATION FORM

Forms

Form Medical card

Christian church Disciples of Christ